고관절 및 슬관절 치환술 후의 심부정맥 혈전증의 연구 :MDCT 정맥사진과 컬러 도플러 초음파의 비교

초록

Purpose; To assess the usefulness of MDCT venography for diagnosis of deep vein thrombosis (DVT) after total knee and hip arthroplasty by comparison with color duplex USG. Material and methods; 22 cases undergoing total knee and hip arthroplasty were prospectively studied for DVT of the lower extremity. No pharmaceutical prophylaxis for DVT was administered. Both MDCT venography and color duplex USG were performed before and 7?4 days after surgery. MDCT venography and color duplex USG were performed same day and interpreted by radiologists who were blinded to the results of other modalities. In each true-positive cases, the location of the thrombus identified with both techniques was compared. Results; DVT was found 10 cases (46%) at MDCT venography, and 9 cases (41%) color duplex USG after surgery. 4 cases were popliteal vein thrombosis and 7 cases were calf vein thrombosis. There were no DVT at MDCT venography and color duplex USG before surgery. When comparing MDCT venography with color duplex USG for the detection of DVT after surgery, the sensitivity measured 90.9%; specificity, 100%; positive predictive value, 100%; negative predictive value, 92%; and accuracy, %. Conclusions; Although, cases are relatively small, MDCT venography is high accuracy, fast, and convenient in evaluation of DVT after total knee and hip arthroplasty patient. So, MDCT venography is a reasonably good alternative to duplex color USG in the diagnosis of DVT after total knee and hip arthroplasty. Also, MDCT venography can be perfomed as part of the suspected pulmonary embolism after total knee and hip arthroplasty, and can be a comprehensive modality in evaluation of the venous system of leg, pelvis, abdomen, and chest.